Trauma re-engagement and PTSD in older medically ill veterans: implications for trauma-informed care

Abstract

Objectives

We characterize rates and correlates of PTSD and of trauma re-engagement without PTSD in medically ill older Veterans, as well as supportive strategies, with the goal of advancing trauma-informed care.

Methods

We interviewed medically ill older Veterans (N = 88, M age 75.13, SD = 6.14) with primary care screening measures for PTSD and trauma re-engagement, and open-ended questions to assess supportive strategies.

Results

One-fifth (20.5%) presented with probable PTSD, associated with greater trauma exposures (r=.57, p<.001), whereas two-fifths (43.2%) reported re-engagement with military memories without PTSD, associated with having a spouse/partner (t = 2.27, p=.028). Of those who experienced trauma, half reported thinking more about the trauma recently and becoming more emotional on certain days. In response to the question ‘What gives you strength as you think about the future with your illness’ Veterans described support of family, healthcare, worldview, personal control, acceptance, and health behaviors.

Conclusion

Memories of trauma are common with medical illness. Age-friendly trauma-informed care could consider factors that patients describe as sources of strength with illness.

Keywords:

• PTSD
• trauma
• veterans
• resilience
• trauma-informed care
• age-friendly
• mental health
• mood disorders
• anxiety and trauma related disorders; stress
• trauma

Disclosure statement

No potential conflict of interest was reported by the authors.

Ethics/IRB review

This study was reviewed and approved by the VA Boston Research and Development Committee and Human Studies Committee #3173 (IRBNet 1583605).

Impact statement

We certify this work is novel. This work adds to the literature by describing how memories of trauma may worsen with medical illness – some of which represent PTSD while others represent later adulthood trauma re-engagement – a newer concept less familiar to some healthcare providers. Further this work has the potential to impact clinical care for older veterans - a special population of older adults – by describing how the results can be applied within a trauma-informed care model.

Additional information

Funding

This work was funded by the Rx Foundation [no grant number]. The sponsor did not have a role in study design, acquisition of participants, analysis, data interpretation, or preparation of the manuscript.